Background: Meningitis, is a potentially life-threatening condition that can rapidly progress to permanent brain damage, neurologic problems, and even death. Bacteria and viruses cause the great majority of meningitis disease in infants and children. CRP is used mainly as a marker of inflammation.Objective: This study was conducted to assess the diagnostic value of CSF-CRP levels for differentiating between septic (bacterial) and aseptic infantile meningitis.Methods: 49 hospitalized infants aged less than two months with suspected meningitis were enrolled in a cross-sectional analytic study. All of patients underwent lumbar puncture to obtain CSF. smears, cultures, cytological and biochemical analysis and latex agglutination testing were carried out on all CSF samples. Latex agglutination test was carried out on all CSF samples using a commercially available kit. CSF-CRP level of all infants was measured using the immunoturbidometric technique.Results: Of 49 infants in this study, 20 and 29 cases were diagnosed as septic and aseptic meningitis, respectively. The CRP levels were obtained as 0.95±0.68 mg/L in septic and 0.16±0.36 mg/L in aseptic meningitis groups and this difference was statistically significant (p<0.001) between the two groups (0.79±0.32 mg/L). Based on the ROC curve, cut off levels for CRP was obtained 0.17 mg/L. At this level, there was 95% sensitivity and 86% specificity to differentiate septic and aseptic meningitis.Conclusion: CSF-CRP has suitable diagnostic value in distinguishing between infantile bacterial from aseptic meningitis especially in cases of negative bacterial culture of the blood and spinal fluid.Keywords: C-reactive protein, cerebrospinal fluid, septic/aseptic meningitis, infant, diagnostic value.
Positive PCR in SF (4%) definitely indicates active infection and M. pneumonia induced arthiritis. Although positive SF-IgM (4%) suggests either a current or a very recent M. pneumonia infection but not for SF-IgG (previous infection). So, we can summate that PCR, though being the best and most accurate method to detect M. pneumonia infection arthritis, is not considered a practical one due to costs and availability issues. Hence it can be safely replaced by serology test (Specific IgM) in SF for diagnosis of M. pneumonia arthritis, which is available in most of the hospitals and is much more economical as compared to PCR.
Helicobacter pylori (H. pylori) is a bacterium that resides in the human stomach, which is associated with gastroduodenal diseases. We investigate the prevalence of cagA, vacA, oipA, cagE1, cagE2 and dupA genotypes in H. pylori isolated from patients with Gastric ulcer, duodenal ulcer, and Gastric Cancer. Collected 74 samples from the Gastroenterology Unit of the Rasool Akram Hospital were included in this study. Gastric disorders were identified by endoscopy .gastric cancer was further confirmed by histopathology. H. pylori were detected by the urease test. Subsequently, DNA was extracted from gastric tissue of the subjects with the CLO-test yielded positive results. In general, 74 patients with a mean age of 53.45 years (Range 22 to 86-year-old), including 45 men and 29 women, were studied. Among 74 H. pylori-positive patients, 70 (94.5%) patients were positive for the cagA gene. About 95.8% (23/24) of the patients with gastric carcinoma were dupA positive and VacA gene (91.8%). The oipA genotype was detected in 71 (96%) of H.pylori positive samples. This gene was more common in patients with gastritis rather than cancer group. Also, 97.2% of 74 H. pylori isolates were cagE2-positive. In 25 patients with PUD, the occurrence percent of cagA+/VacA+, cagA+/Vac- , cagA- /VacA+ and cagA- /VaxA- genotypes were found 80%, 12%, 4.2% and 4.2 respectively. The results of the present study suggest that a high prevalence of virulent factors could contribute to the risk of developing gastroduodenal diseases.
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